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DR. MATTHEW JAMES HILEMAN DO
NPI 1912357161
Psychiatry & Neurology - Neurology in Springfield, IL

Active since June 19, 2016PECOS EnrolledAccepts Medicare Assignment
63.63/100
CMS Quality Rating
751 N RUTLEDGE ST, SPRINGFIELD, IL 62702(217) 545-8000 Get Directions Write a Review

NPPES record last updated: December 1, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 1, 2025, Jun 19, 2016 (2 updates tracked since 2016).

About Dr. Matthew James Hileman Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MATTHEW JAMES HILEMAN DO (NPI 1912357161) is an individual neurology provider in Springfield, Illinois, licensed in Illinois (125.068946) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital Southeast, and maintains a secondary practice location in North Kansas City.

NPPES Registry Identity

NPI1912357161
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameDR. MATTHEW JAMES HILEMANCredential: DO
Location Address751 N RUTLEDGE STSpringfield, IL 62702-4968
Mailing AddressPo Box 19643Springfield, IL 62794-9643 · (217) 545-8000
Phone(217) 545-8000
Sole ProprietorNo
Medical School CMSAt Still University Of Health Sciences, College Of Osteo Med, KirksvilleGraduated 2016
Enumeration DateJune 19, 2016
Last NPPES UpdateDecember 1, 20252 updates tracked since enumeration
NPPES CertifiedDecember 1, 2025
✔ NPI 1912357161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Licenses✔ Licensed in IL · 125.068946✔ Licensed in MO · 2020021405
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
751 N RUTLEDGE ST, Springfield, IL 62702
Open in Google Maps ↗

Secondary Practice Location 1

Location 12790 Clay Edwards Dr Ste 1235North Kansas City, MO 64116-3276 · Phone (816) 472-5157 · Fax (816) 472-7201

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Matthew James Hileman Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931495397
PECOS Enrollment IDI20200904000667, I20260603004502
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
187 services124 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
155 services59 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
138 services67 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
107 services78 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
53 services52 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
49 services39 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Hospital Southeast

Acute Care Hospitals · Cape Girardeau, MO
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260110
Location1701 Lacey StCape Girardeau, MO 63701 · Cape Girardeau County
Emergency services Birthing friendly

Missouri Delta Medical Center

Acute Care Hospitals · Sikeston, MO
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260113
Location1008 North Main StSikeston, MO 63801 · Scott County
Emergency services Birthing friendly

Mercy Hospital Stoddard

Acute Care Hospitals · Dexter, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260160
Location1200 N One Mile RdDexter, MO 63841 · Stoddard County
Emergency services

Mercy Hospital Perry

Critical Access Hospitals · Perryville, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number261311
Location434 North West StreetPerryville, MO 63775 · Perry County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62702 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

63.63/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality20.19
Promoting Interoperability100
Improvement Activities40
Cost58.59

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ZACHARIAH GURNSEY MD
Internal Medicine
751 N RUTLEDGE ST, STE 1100
SPRINGFIELD, IL 62702
Sangamon County (217) 545-0182
CATHERINE A NARITOKU R.D.
Dietitian, Registered
751 N RUTLEDGE ST, LOWER LEVEL
SPRINGFIELD, IL 62702
Sangamon County (217) 545-0182
MRS. LUCINDA S BUESCHER M.D.
Dermatology
751 N RUTLEDGE ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-3821
JAMES M GILCHRIST MD
Psychiatry & Neurology (Clinical Neurophysiology)
751 N RUTLEDGE ST, STE 3100
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000
DR. AKSHRA VERMA MD, MS
Internal Medicine
751 N RUTLEDGE ST, STE 1100
SPRINGFIELD, IL 62702
Sangamon County (217) 545-0182
CYNTHIA A MICHAEL MD
Internal Medicine (Pulmonary Disease)
751 N RUTLEDGE ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000
TILITHA S SHAWGO
Clinical Nurse Specialist (Acute Care)
751 N RUTLEDGE ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-4421
REBECCA J LARSON MD
Dermatology (MOHS-Micrographic Surgery)
751 N RUTLEDGE ST, SUITE 2300
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Hileman's NPI number?

The NPI number for Matthew Hileman is 1912357161. It was assigned to this individual provider in the NPPES registry on June 19, 2016.

Where is Matthew Hileman located?

Matthew Hileman practices at 751 N Rutledge St, Springfield, IL 62702. The listed phone number is (217) 545-8000.

What is Matthew Hileman's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Matthew Hileman enrolled in Medicare?

Yes. Matthew Hileman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Matthew Hileman accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 4 other insurers list Matthew Hileman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Matthew Hileman affiliated with any hospitals?

According to CMS data, Matthew Hileman is affiliated with Mercy Hospital Southeast, Missouri Delta Medical Center, Mercy Hospital Stoddard and Mercy Hospital Perry.

When was this NPI record last updated?

The NPPES record for Matthew Hileman was last updated on December 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.